Negative teen mental health exacerbated by the COVID-19 pandemic

  • About 37% of teens surveyed by the CDC reported poor mental health in 2020.
  • At least 73% reported at least one adverse childhood experience (ACE).
  • ACEs are associated with an increased risk of mental health problems and increased suicidal thoughts.

Many people are reporting concerns about the effects of COVID on mental health. Teenagers in particular were affected after dealing with social distancing and not attending school. In addition, many experienced traumatic events during the pandemic.

Now the CDC recently released a report on the COVID-19 pandemic and adolescent mental health. About 37% of respondents reported poor mental health in 2020. At least 73% reported at least one adverse childhood experience (ACEs) during that time, and 12% experienced three or more.

Those who experienced ACE were more likely to report mental health problems and suicide attempts than those who did not.

The report surveyed 4,390 high school students and asked them if they had experienced various ACEs during the COVID outbreak or in the past 12 months. The students were also asked about their overall mental health, whether during that time they had experienced long periods of sadness or hopelessness, and whether they had thought about or attempted suicide.

ACEs were grouped by type and number experienced, and those who experienced one or more had their mental health outcomes compared to those who did not report any ACEs during that time period. The researcher reported that 1,167 teenagers had no ACEs, 2,358 one or two ACEs, 512 three, and 353 four or more.

Adverse childhood experiences are a variety of experiences that are known to be traumatic or upsetting to those who experience them.

These include witnessing or being a victim of violence, drug and/or alcohol abuse, food insecurity, and death of parents or other family members, being away from family or in prison.

ACEs are commonly associated with mental health problems and increased suicidal ideation. Although there are no comparable studies showing the number of ACEs in schoolchildren before the pandemic, a study asking adults about childhood ACEs found that 60.9 percent reported at least one and 15.6 percent reported four or more.

The number of ACEs students report has a direct and negative effect on their mental health. About 30% of those who reported at least one ACE reported poor mental health in the past 30 days, and about 65% of those who reported four or more ACEs said the same.

In contrast, only about 15% of those who did not have an ACE said the same. Groups who experienced at least one ACE were more likely to report poor mental health during the 2020 COVID pandemic and persistent feelings of sadness or hopelessness.

About 20% of those who reported at least one ACE said they had felt actively suicidal in the past year. If they have experienced four or more ACEs, this percentage rises to about 55%.

The rate of actual suicide attempts ranged from less than 5% in those who had no ACEs to at least 35% in those who had four or more.

“This study demonstrates the devastating mental/social/emotional negative effects in just a small period of time,” said Dr. Shona Newman, a psychiatrist at Lenox Hill Hospital in New York. “These data reflect the devastating effects of the pandemic on youth and the rapidly escalating negative impact on mental health, exacerbated by the lack of sufficient resources and services to serve young people’s needs.”

Lynn F. Bufka, MD, ABPP, associate chief of practice transformation at the American Psychological Association, said reducing ACEs should be a goal for health care providers.

“At the same time, increasing the other side of the balance—that is, increasing the resources available to the student to deal with difficulties—is essential. This includes addressing systemic disparities (such as disparities in neighborhood safety or access to health care or school nutrition), as well as supporting the development of psychological and cognitive skills to cope with distress (through school-based social-emotional learning programs or providing access to mental health counselors or a range of other options), Bufka said.

The CDC acknowledges that the study is limited and more research is needed.

No variables other than the number of ACEs were included in the mental health assessments, and other aspects of the COVID pandemic may have influenced the results. Additionally, only seven ACE categories were included. This may mean that some teenagers had an ACE that did not fall into these categories and were then considered not to have had an ACE.

Because the study was self-reported, some subjects may not have reported any mental health problems or ACEs they had.

CDC still reports that adolescent ACE prevention is an important part of mental health intervention and that the COVID pandemic may have influenced the number of ACEs and/or the effect they had on subjects.

The CDC authors suggested providing family economic support and connecting students and parents to available community mental health resources.

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